- Humana (Providence, RI)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by… more
- Humana (Providence, RI)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... requires an in-depth evaluation of variable factors. **Description** The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Providence, RI)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Providence, RI)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
- Humana (Providence, RI)
- …our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. ... The Corporate Medical Director works on problems of diverse scope and complexity...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Humana (Providence, RI)
- …are seeking an accomplished healthcare physician leader for the newly-created role of Director , Physician Leadership. In this role, you will be a key enterprise ... health outcomes for some of our most vulnerable members. The Director , Physician leadership will lead Medical Directors performing utilization management for… more
- Humana (Providence, RI)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director works on problems of diverse scope and complexity...appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents… more
- Sumitomo Pharma (Providence, RI)
- …We are seeking a strategic and collaborative leader to join us as **Associate Director , Marketing - Oncology** . This role offers a unique opportunity to shape and ... brand planning, marketing strategy, or field support strongly preferred. * Oncology or specialty pharma experience is a plus. * Proven track record of leading… more
- Norstella (Providence, RI)
- Sr. Director , RWD Analytics and Innovation (Healthcare & Life Sciences) Company: Norstella Location: Remote, United States Date Posted: Jul 18, 2025 Employment Type: ... faster + The Dedham Group - think strategically for specialty therapeutics By combining the efforts of each organization...:** We are seeking a dynamic and visionary Senior Director of RWD (Real-World Data) Analytics and Innovation to… more
- Sanofi Group (Providence, RI)
- …requires dedicated and knowledgeable customer facing support. Field Reimbursement Manager/ Director for TZIELD. This is a regionally aligned, field-based position ... general inquiries via phone or email + Work with specialty pharmacies and specialty distributors + Coordinate...address coverage and reimbursement matters + Stay educated about compliance and OIG guidance and policies regarding patient support… more
- Sodexo (Providence, RI)
- …Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. The major teaching affiliate of The Warren ... with the Environment of Care Committee and Infection Prevention Director + effectively manages the Unit Operating System +...leadership skills and can work independently to drive program compliance and reach project target dates of completion +… more